• Thứ 3, 11/08/2020
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Gía trị cộng hưởng từ phổ trong chẩn đoán ung thư tuyến tiền liệt

Gía trị cộng hưởng từ phổ trong chẩn đoán ung thư tuyến tiền liệt

03/25/2020 22:33:20 | 0 binh luận

The value of magnetic resonance spectroscopy in diagnosis of prostate cancer


Purpose: The aim of study was to determine the value of MRS in diagnosis of prostate carcinoma especially for differentiating begnin from malignant lesion of the prostate.

Materials and methods: During a period of 4/2014 to 6/2016, 25 consecutive patients with elevated PSA level or clinical suspiciousness were evaluated with MRS of the prostate. The results were confirmed by TRUS-guided biopsy. We compare two groups (prostate carcinoma/PCa and prostate non-caricnoma/PNCa) by variant: mean of the choline plus creatine -to- citrate. Analyzing ROC curve to find the value of MRS in differentiating begnin from malignant tissue of the prostate.

Results: Patients range in age from 40 to 89 years (mean 71 ± 12 year). 08 patients were confirmed to have PNCa (32%), whereas 17 patients had PCa (68%). The mean of (Cho+ Cr)/Ci values for PNCa and PCa were 0.50± 0.31 and 2.64± 1.22 respectively. The mean of (Cho+Cr)/ Ci value of PCa was significantly higher than PNCa (p<0.05). On ROC curve, using discrimination threshold of (Cho+Cr)/ Ci is 0.84, the MRS provided a sensitivity of 94.1%, specificity of 87.5% for differentiating NPCa from PCa.

Conclusion: Magnetic Resonance Spectroscopy of the prostate can be use to differentiate begnin from malignant tissue with high accuracy.

Key words: Prostatic carcinoma, non-carcinoma, Magnetic resonance spectroscopy, TRUS.

Chất tương phản MRI - PRIMOVIST: Vai trò trong chẩn đoán thương tổn gan

Chất tương phản MRI - PRIMOVIST: Vai trò trong chẩn đoán thương tổn gan

03/22/2020 19:18:01 | 0 binh luận

The role of hepatobiliary specific MR cantrast agent in the diagnostic focal liver lesion


Purpose: Assessing the role of hepatobiliary - specific MR contrast Agent in the detection and differentiation of benign and malignant focal liver lesions. Maximizing accuracy of imaging in the context of focal liver lesions is paramount in avoiding unnecessary biopsies, which may result in post-procedural complications.

Methods and Materials: Retrospectively evaluated the 200 patients cases, executed hepatic MRI at Medic Medical center wich hepatobiliary - specific MR contrast Agent. From on January 2013 to on January 2016, age range 28 - 72years. The lesion detected in liver: 65 cases HCC, 5 Metastasis, 2 cholangiocarcinoma, 2 Adenoma, 26 FNH, 24 Hemangiomas, 14 Regenerative nodules, 20 cysts, 5 Abscess, 37cases had normal liver. All the patients executed T2WI fatsat, Diffusion weighted imaging - MRI with three b values (0, 500, 800 sec/mm2) and Dynamic with Primovist contrast media on the Siemens Avanto 1,5T MRI.

Results: In 65cases MRI HCC: 8 cases <1cm; 32 cases 1-2cm; 25 cases >25cm. 26 cases biopsic result: 24 cases HCC (92%), 2 cases cholangiocarcinoma, 39 cases TOCE or RFA no biopsy. 5 cases metastas detected primary tumor. 2 cases cholangiocarcinoma are right with biopsic result. 2 cases adenoma: 1case biopsic resulted in adenoma, 1 case follow up over 1year. 25 cases hemangiomas with contrast media from peripheral enhancement progressing to centre of lesion; 12 cases regenerative nodules is follow up over 1 year no change in nodule size; 20 cysts are high-signal intensity like fluid - signal on the T2WI, T1WI, Diffusion and no change of intensity is found after contrast injection; in 5 cases abscess: 3 cases recovered from an illness, 2 cases HCC after biopsy.

Conclusion: Magnetic resonance imaging executed with hepatobiliary - specific MR contrast Agent, contributed to detect the small lesion and differential diagnosis between benign and malignant tumor of the liver.

Đặc điểm hình ảnh 18F-FDG PET/CT não ở bệnh nhân Alzheimer và ở người lão hóa bình thường

Đặc điểm hình ảnh 18F-FDG PET/CT não ở bệnh nhân Alzheimer và ở người lão hóa bình thường

03/25/2020 22:45:48 | 0 binh luận

Imaging characteristics of brain 18f-fdg pet/ct in alzheimer’s disease patients and in normal elderly persons


Purpose: Define 18F-FDG PET/CT cerebral imaging characteristics in Alzheimer’s Disease patients and in the normal elderly persons (Nls).

Objects and Methods: From 2014 to 2015, 26 Alzheimer’s disease patients and 20 normal elderly persons undergone brain 18F-FDG PET/CT scans.

Results: Mean age of Alzheimer’s disease patients is 66,3±8,2 years old and 64,2±8,1 in Nls. Homogenous 18F-FDG cerebral uptake in Nls. Most of cerebral regions in Alzheimer’s disease patients suffering from a reduction of mean SUV. Rate of 18F-FDG hypometabolism in medial temporo-hippocampal area in 96.2% of cases on left side, meanwhile 92.3% of cases having a hypometabolism in right medial temporo-hippocampal area as well as in bilateral posterior cingulate gyrus, 76.9% in temporo-parietal area on right side and 86.5% on left side. Cerebral metabolism in occipital lobes principally reserved. Hypometabolism affecting bilateral frontal lobe in a half of cases. Brain glucose metabolism partially reserved at primary moto-sensory cortices, cerebellum, as well as in anterior cingulate gyrus, especially reservation of glucose metabolism at basal ganglias in Alzheimer disease (96,2%). Rate of glucose hypometabolic Alzheimer like patterns in 92,3% of cases with 84,6% on both sides.

Conclusion: No focal cerebral cortical hypometabolism in Nls. Evident reduction in 18F-FDG uptake of cerebral cortices in Alzheimer’s disease patients in compared with Nls. Imaging characteristics of hypometabolism in 18F-FDG PET/CT brain scan in Alzheimer’s disease patients are regional anatomically and specifically with high rate in medial temporo-hippocampal, posterior temporal, temporo-parietal and posterior cingulate areas, well correspondent to wellknown glucose metabolic patterns in Alzheimer’s disease.

Key words: Alzheimer’s Disease (AD), Brain 18F-FDG PET/ CT, imaging characteristics.

Hình ảnh cắt lớp vi tính và cộng hưởng tử bất thường dây thần inh ốc tai trên 22 bệnh nhân  điếc tiếp nhận bẩm sinh

Hình ảnh cắt lớp vi tính và cộng hưởng tử bất thường dây thần inh ốc tai trên 22 bệnh nhân điếc tiếp nhận bẩm sinh

04/07/2020 21:04:15 | 0 binh luận

CT scanner and MRI imagingof cochlear nerve deficiency in 22 patients with bilateral congenital sensorineural hearing loss


Objective: To describe CT scanner and MRI imagingof cochlear nerve deficiency (CND) and cochleovestibular nerve abnormality in association with cochlear aperture, internal auditory canal (IAC) and labyrinthine malformations.

Material and Methods: 22 patients with CNDin 43 ears. Aplasia or hypoplasia of the cochlear branch was evaluated on high resolution 3D gradient-echo MRI. Cochlear aperture, IAC and bony labyrinthine malformations was evaluated on high resolutionCT scanner.

Results: 22 patients with CNDin 43 ears. Cochlear nerve aplasia in 20 ears (46,5%), cochlear nerve hypoplasia in 2 ears (4,7%), presence of vestibulocochlear nerve with no cochlear branch in 21 ears (48,8%). Labyrinthine malformation in 25 ears (58,1%).The mean IAC diameter 3,03 ± 1,03mm.Cochlear aperture stenosis and atresia 76,7%.

Conclusion:CND frequently associated with labyrinthine malformations, cochlear aperture stenosis or atresia and IAC stenosis.

Key words: Cochlear nerve deficiency, CT scanner and MRI.

Đánh giá kết quả điều trị nút mạch hóa dầu kết hợp truyền CISPLATIN trong ung thư gan có huyết khối tĩnh mạch cửa

Đánh giá kết quả điều trị nút mạch hóa dầu kết hợp truyền CISPLATIN trong ung thư gan có huyết khối tĩnh mạch cửa

03/17/2020 16:39:48 | 0 binh luận

Evaluate treatment results of ctace combine with intratumoral injection of cisplatin in hepatocellular carcinoma with major portal vein thrombosis


Advanced stage hepatocellular carcinoma with portal vein thombosis has worse prognosis and limited treatment. Transarterial chemoembolization use Lipiodol combined Cisplatin intratumoral is a safe method and have efficacy in treatment.

Objective: To evaluate safety and efficay of cTACE combine with intratumoral injection of Cisplatin for hepatocellular carcinoma with major portal vein shunt treatment.

Methods: From May 2018 to May 2019, 24 patients who had diagnosis of HCC with major portal vein thrombosis were perfomed cTACE (Famorubicin + Lipiodol) combined with intratumoral injection of Cisplatin. The patients were followed after treatment 1 week for the clinical symptom and after 1 month, used mRECIST and tumor markers (AFP or PIVKA-II) to aveluated treatment efficacy. The patients were perfomed consecutive courses of treatment and followed until died or until the end of study.

Results: 24 patients (21 males, 3 females), age mean is 54,4 (from 32ys to 72ys, AFP mean 15600 ng/ml (from 3 to 121000), 19 patients (79%) has size of tumor ≥5cm. The classification of portal vein thrombosis: 6 patients Vp1 and Vp2; Vp3 18 patients. Total courses of treatment was 38 times. 15 patients (62,5%) had post embolization syndrome, 8 patients (33,3%) had decreasing of tumor marker. mRECIST: CR 3 patients (12,5%); PR 6 patients (25%); SD 4 patients (16,7%); PD 11 patients (45,8%). The mean survival time was 9,9 ± 1,1 months. The survival times is depend on the classification of PVTT (p=0.037 the mRECIST respondsibility (p=0.0001), the decreasing of tumor markers (p=0.01) and isn’t depend on the AFP before procedures.

Conclusions: cTACE combine with intratumoral injection of Cisplatin is safety an have efficacy on treatment of HCC with major portal vein thrombosis.

Keyword: Hepatocellular with portal vein thrombosis, cTACE, Cisplatin injection.

Đánh giá kết quả điều trị tiêm xơ dị dạng tĩnh mạch dưới hướng dẫn DSA

Đánh giá kết quả điều trị tiêm xơ dị dạng tĩnh mạch dưới hướng dẫn DSA

03/17/2020 16:57:22 | 0 binh luận

Evaluation the result of flouroscopy-guided sclerotherapy in treating superficial venous malformation


Objective: Describe characteristics imaging of superficial venous malformation (VM) on flouroscopy and evaluate effectiveness of foam sclerotherapy.

Methods: Prospective and retroprestive cohort from November 2015 till July 2019 on 17 patients with VM treated by flouroscopy-guided sclerotherapy with 21 lesions and 46 seasons sclerotherapy. Evualating results of treatment based on improvement in symtomps ( pain- Visual Analogue Score) and imaging ( MRI- repeat MRI after last season for 6 months . There are 4 grade in improvement in imaging: excellent ( reduction in size of lesion over 90 %), good ( reduce 50 -90 %), average ( 10-50 %) and no reponse ( less 10 %). Evualating recurrence based on increasing pain score (VAS) or size in MRI. Using SPSS 20.0 to analize and process data.

Results: 17 patients (7 males and 11 females) with VM were involved in our study. Patients were a mean of 26.5± 12.9 years old ( range: from 6 to 59). Evualated by digital subtraction angiography, the lesion were categorized into 4 types according to the venous drainage features. Of the 21 lesion: 3/21 had type I (14.3 %), 12/21 had type II (57.1 %); 2/21 had type III (9.5 %) and 4/21 had type IV (19 %). Total seasons are 46. 8/21lesions (38.1 %) achieved excellent response, 9/21 (42.9 %) achieved good response, 3/21 (14.3 %) achieved average response and 1 patient (4.8%) no response in magnetic resonance imaging in magnetic resonance imaging assessments. Mean VAS scores after treatment for 1 month: 1.4; 3 months: 0.9; 6 months: 1.1, min: 0, max: 5. The long- term recurrence rates with follow-up time from 1 to 2 years is: 3/4 patients had recurrence (75 %) include of 1 patients had increasing imaging and pain score, 2 patients just had only increase imaging in MRI.

Conclusion: Flouroscopy-guided sclerotherapy is a safe and effective procedure to reduce size and pain for patient with venous malformations that have symptoms. But the long – term recurrence rates is quite high.

Keywords: venous malformation, sclerotherapy, flouroscopy-guided

Bước đầu đánh giá hiệu quả của phương pháp đốt sóng cao tần nhân lành tính tuyến giáp có triệu chứng

Bước đầu đánh giá hiệu quả của phương pháp đốt sóng cao tần nhân lành tính tuyến giáp có triệu chứng

03/17/2020 16:32:47 | 0 binh luận

Evaluation of the early efficacy of radiofrequency ablation for benign thyroid nodules in symptomatic patients


Objective: To evaluate the early efficacy of radiofrequency (RF) ablation for treatment of benign thyroid nodules, which causes symptoms in the Department Radiology- Bach Mai Hospital.

Methods: We evaluated 51 benign thyroid nodules from 43 patients treated with RF ablation between 10/2016 and 4/2017. The procedure began with examining and diagnosing an benign thyroid nodules which causes symtoms by clinical physicians. The patients were diagnosed with a benign thyroid nodule according to the TIRADS classification combined with at least two appropriate results of cytology or biopsy by radiologists. The patients were then considered and performed radiofrequency ablation treatment for benign thyroid nodules. The follow-up examinations took place 1 month after RF ablation.

Results: (1) 94% of the tumors needed only one time of RFA; (2) One treatment duration of RFA lasted an average of 21.8 minutes, (3) 76% of the tumors decreased by 30-50% volume, 11 % decreased by > 50% volume. (4) 100% of the treated individuals will reduce perfusion. (5) 96.4% of patients reduced or lost their symptoms. (6) There were no major complications during treatment, minor side effects (neck pain, bleeding,voice change …) restored after 2 weeks maximum.

Conclusion: Radiofrequency ablation is a minimally-invasive method and an effective treatment for symptomatic thyroid nodules that are confirmed benign.

Keywords: Thyroid nodule, benign thyroid nodule, symptomatic thyroid nodule, treatment for thyroid nodules, radiofrequency ablation.

Đánh giá hiệu quả điều trị trung hạn suy tĩnh mạch mạn tính bằng phương pháp can thiệp nội mạch

Đánh giá hiệu quả điều trị trung hạn suy tĩnh mạch mạn tính bằng phương pháp can thiệp nội mạch

03/17/2020 16:18:24 | 0 binh luận


Objectives: The aim of this work was to evaluate the outcomes after the endovascular interventions for chronic venous insufficiency of the lower limbs.

Methods: This study was conducted on 60 patients diagnosed with chronic venous insufficiency of the lower limbs at the Radiology Center, Bach Mai Hospital, 2018 – 2019. Convenience sampling technique was used for this study.

Results: Endovenous laser ablation was indicated for 40 patients and endovenous radiofrequency (RF) ablation was for 20 patients, showing all patients were removed from the reflux line. For the patients with laser ablation, the mean Venous Clinical Severity Score (VCSS) were 3,67 ± 3,58 (0-11) before the treatment; 1,22 ± 2,03 (0-6) at 1 month; and 0,41 ± 1,01 (0-4) at 12 months. For the patients with RF ablation, the mean VCSS were 3,62 ± 3,45 (0-10) before the treatment; 0,15 ± 0,55 (0-2) at 1 month; and 0,08 ± 0,28 (0-1) at 12 months. 18 cases were recorded the complications after the intervention (30.00%), including dark skin, and paresthesia. 2 cases had the positions with varicose veins after 12 months (3.33%). There were no significant differences in the efficacy and complications amongst endovenous laser ablation and endovenous radiofrequency ablation (p >0.05).

Conclusions: Endovascular intervention is minimally invasive safe effective method that improves long-term better symptoms.

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